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A developmental cascade perspective of paediatric obesity: A systematic review of preventive interventions from infancy through late adolescence.
Obesity Reviews ( IF 8.0 ) Pub Date : 2019-12-06 , DOI: 10.1111/obr.12939
Sara M St George 1 , Yaray Agosto 2 , Lourdes M Rojas 1 , Mary Soares 1 , Monica Bahamon 1 , Guillermo Prado 1 , Justin D Smith 3
Affiliation  

The goals of this systematic review were to identify and describe paediatric obesity prevention interventions from infancy to late adolescence and to provide recommendations for future intervention research in light of a recently proposed developmental cascade (DC) model of paediatric obesity. We conducted an electronic search of randomized controlled trials with a minimum 6‐month postintervention follow‐up published between 1995 and 2019. We included 74 interventions: prenatal/infancy (n = 4), early childhood (n = 11), childhood (n = 38), early to mid‐adolescence (n = 18), and late adolescence (n = 3). Infancy and early childhood trials targeted early feeding and positive parenting skills. Half of the childhood and adolescence trials were school based and used universal prevention strategies; those classified as selective or indicated prevention tended to involve the family for more intensive lifestyle modification. Less than 10% of studies followed participants over long periods of time (greater than or equal to 5 years), and only 16% and 31% of studies assessed intervention mediators and moderators, respectively. We recommend that future interventions focus on early prevention, assess long‐term intervention effects, use a standardized taxonomy for defining intervention behavioural strategies, assess underlying mechanisms of action and intervention moderators, target parent and family management strategies across development, and increase scientific equity. We also provide specific recommendations regarding intervention targets for each developmental stage.

中文翻译:

儿童肥胖的发展级联视角:从婴儿期到青春期后期的预防干预措施的系统回顾。

本系统综述的目的是确定和描述从婴儿期到青春期晚期的儿科肥胖预防干预措施,并根据最近提出的儿科肥胖发育级联(DC)模型为未来的干预研究提供建议。我们对 1995 年至 2019 年间发表的干预后至少 6 个月的随机对照试验进行了电子检索。我们纳入了 74 项干预措施:产前/婴儿期 (n = 4)、幼儿期 (n = 11)、儿童期 (n = 11) = 38)、青春期早期至中期(n = 18)和青春期晚期(n = 3)。婴儿期和幼儿期试验的目标是早期喂养和积极的养育技能。一半的儿童和青少年试验是在学校进行的,并使用了普遍的预防策略;那些被归类为选择性或指示性预防的措施往往要求家庭进行更深入的生活方式改变。不到 10% 的研究对参与者进行了长期(大于或等于 5 年)的跟踪,并且只有 16% 和 31% 的研究分别评估了干预中介因素和调节因素。我们建议未来的干预措施侧重于早期预防,评估长期干预效果,使用标准化分类法来定义干预行为策略,评估潜在的行动机制和干预调节因素,针对整个发展过程中的父母和家庭管理策略,并提高科学公平性。我们还针对每个发展阶段的干预目标提供具体建议。
更新日期:2019-12-06
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